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Japanese Occupational Therapy Research Volume 39, Issue 5 （October 2020）

作業療法 39巻5号（2020年10月発行）

Japanese English

◆原著論文

脳卒中片麻痺上肢へのリーチングロボットを用いたリーチング訓練の上肢機能と日常生活使用への効果 Effects of reach training with Arm Rehabilitation Robot on function and everyday use of hemiplegic upper limbs 木村佳奈 ¹ , 髙見美貴 ¹ , 川平和美 ² Kana Kimura ¹ , Miki Takami ¹ , Kazumi Kawahira ² ¹独立行政法人秋田県立病院機構秋田県立リハビリテーション・精神医療センター ²促通反復療法研究所 ¹Akita Prefectural Center for Rehabilitation and Psychiatric Medicine ²Laboratory of Repetitive Facilitative Exercise キーワード：上肢機能 , 脳卒中 , ロボット , 回復期 , 日常生活 , Upper limb function , Stroke , Robotics , Subacute , Dairy living Keyword: 上肢機能 , 脳卒中 , ロボット , 回復期 , 日常生活 , Upper limb function , Stroke , Robotics , Subacute , Dairy living pp.537-547

発行日 2020年10月15日 Published Date 2020/10/15

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要旨：片麻痺上肢のロボット訓練が，上肢機能や日常生活での使用状況に与える影響についての検証は少ない．今回，回復期片麻痺患者15名（発症から訓練開始までの期間：76±22日，BRS：上肢Ⅲ-Ⅴ，手指Ⅲ-Ⅵ）に，促通機能付き上肢リーチングロボットの上肢リハビリ装置CoCoroe AR²（以下，AR²）でのAR²リーチング訓練（2週間）とサンディングブロック・リーチング訓練（2週間）をA1-B-A2デザインで行い，各期のリーチング回数やFMAとMALの変化を比較した．その結果，MALの改善はA2期で有意で，利き手例ではAR²リーチング訓練とMALの改善と関連があったことから，AR²リーチング訓練は日常生活での麻痺肢の使用拡大につながる可能性がある．

　Objective: To evaluate the effects of reach training with Arm Rehabilitation Robot on functions and daily use of hemiplegic upper limbs. The robot utilized computer controlled Motor-load-relieving and facilitation functions using electrical/vibratory stimulation (AR² robot). Subjects: The sample consisted of 15 stroke patients (age: 61±12 years, time after onset: 76±22 days, Brunnstrom Recovery Stage: upper limb Ⅲ to Ⅴ, hand Ⅲ to Ⅵ, affected side: right 8/left 7, left handed 1). They were selected from stroke patients who were admitted to our rehabilitation center between 2016 and 2018. Method: A crossover design (A1-B-A2: A, reach training with AR² robot for 15 min, B, reach training with sanding block for 15 min) across individuals was used. Basic rehabilitation included the repetitive facilitative exercise (RFE) for hemiplegia and task-specific training with Transfer package. Fugl-Mayer Assessment (FMA) for upper limb and hand, Motor Activity Log (MAL), Amount of Use (AOU), and Quality of Movement (QOM) were evaluated at 2-week intervals. Results: Except for the second AR² robot reach, significant improvements in FMA of upper limb and hand were seen after the first AR² robot reach and SB reach, and some improvements of MAL (AOU and QOM) were seen in the second AR² reach. Regarding MAL (AOU and QOM), improvements were associated with AR² reach, and deteriorations were associated with sanding block reach in patients with failure of the dominant hand. Conclusions:AR² robot reach might be effective to improve everyday use of hemiplegic upper limbs.